1980, 11-17 Permit: 80B-3858 WoodstoveAPPLICATION/PERMIT
SPOKANE COUNTY - BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
JOB ADDR SS
1. .S. 0-7 re5-r �tj LEGAL DESCRIPTION - SEE ATTACHED
LOT I BLOCK ISUB-51VISION PARCEL NUMBER/S
2. a w
OWNER nj �
3. V
ADDRESS 4-107
05 s
PHONE
�.Z C2 '
Actual Set Backs in Feet
North South
CONTR�ACJOIA
PHONE
Size of Parcel
Zone Classification
4'
ADDRESS
ZIP
Type Const.
Occupancy
Sprinklered
❑Yes [:]No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5'
ADDRESS
ZIP
Main Floor I Upper
Floors
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
s.
TYPE NEW ❑ ALT. El AD'N. ❑ RPL. EIMVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellinc
7, OF_/ 1:1 OTHER
WORK E) BLD. 1-1PLMB. UQ MECH. ❑ M.H. POOL
CERTIFICATE
Req'd.
Recd.
Not Req'c
of EXEMPTION
DESC� IE WORK
8 �OcIn
Enum. Dist.
Location (Area)
FEES COLLECTED
VALUATION
SOURCE
GAS
ELECTRIC
WATER
SEWER
Ownership
USE CODE
9.
OF
I UTILITIES
I
Public 11 Private El
Single $
1 hereby certify that I have read and examined this application and have read the
"NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The gr
of a permit does not presume
Building
to give authority to violate or cancel the provisions of any other state or to
I la
regulating const ruc n or the
performance of construction. SEEREVERSE SIDE FOR REQUIRED INSPE
TION
Plumbing
I
t �?
JG
DATE OF APPLICATION SIGNATURE OF APPLICAN
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS:
I
NAME D/
Plan Check
Env. Health
Planning
Fire Marshall
Co. Engineer
Utilities
Plans Examiner
SEPA Checklist
ding T ian
SEPA
Mobile Home
Other (Specify)
TOTAL $ ?' L)Q
WHEN MACHINE VALIDA7
THIS BECOMES A PERMIT.
PERMIT IS NONTRANSFERABLE
PERMIT EXPIRES ONE YEAR FROM DATE OF ISSUANCE DATE ISSIIFn
PERMIT NUMBER
870f;— 3185
L`4* *700
*7.006
A *0,OC
385.7'
11-17-80
6479.
IN THIS SPACE,
3'8'18'9 * Z0 0 a F
PFRMIT Nn TOTAI
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